US20120143035A1 - System and Method for Assessing Risk of Glaucoma Onset - Google Patents
System and Method for Assessing Risk of Glaucoma Onset Download PDFInfo
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- US20120143035A1 US20120143035A1 US13/371,122 US201213371122A US2012143035A1 US 20120143035 A1 US20120143035 A1 US 20120143035A1 US 201213371122 A US201213371122 A US 201213371122A US 2012143035 A1 US2012143035 A1 US 2012143035A1
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
- G09B23/30—Anatomical models
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/50—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16Z—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR
- G16Z99/00—Subject matter not provided for in other main groups of this subclass
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/0016—Operational features thereof
- A61B3/0025—Operational features thereof characterised by electronic signal processing, e.g. eye models
Abstract
A system and method for predicting the onset of glaucoma uses a Finite Element Model (FEM) to obtain a response profile of the Optical Nerve Head (ONH) inside an eye. To do this, the FEM is programmed with data from first and second images of the ONH that are respectively taken at the beginning and the end of an imposed pressure differential (e.g. over a range of about 8 kPa). The FEM is then subjected to a sequence of pressure increments and the resultant profile is compared with empirical data to predict an onset of glaucoma.
Description
- This application is a divisional of application Ser. No. 12/397,954, filed Mar. 4, 2009, which is currently pending. The contents of application Ser. No. 12/397,954 are incorporated herein by reference.
- The present invention pertains generally to ophthalmic diagnostic systems and methods for their use. More particularly, the present invention pertains to systems and methods that are used to predict the onset of glaucoma before symptoms of the disease become apparent. The present invention is particularly, but not exclusively, useful as a system or method for using a Finite Element Model (FEM) to predict the onset of glaucoma.
- Glaucoma is a medical condition where increased pressure within an eyeball causes a gradual loss of sight. Although glaucoma can not be cured, if detected early enough it can be controlled by medications, surgery, or both. In any case, the important thing is to have early detection. In the early stages of the disease, however, there are few detectable symptoms that are glaucoma specific. Nevertheless, there are certain risk factors, such as age, race, and family history, in addition to hypertension, which can indicate that an early detection (prediction) of glaucoma may be prudent. Stated differently, it may be desirable to identify candidates early on for the pharmacological treatment of glaucoma. And, consequently, to thereby determine a properly required pharmacological regimen, including the type and strength of medications to be used.
- It is known that an increased intraocular pressure (IOP) inside the eyeball causes glaucoma. An increased IOP also causes noticeable anatomical changes in the eye. In particular, as a consequence of the increased IOP, changes in biomechanical stress conditions in the Lamina Cribrosa (LC) of the Optical Nerve Head (ONH) are observable. Importantly, these observations can be evaluated to determine whether any damage to the LC is due to an increase in IOP. If so, glaucoma may be indicated. On the other hand, a healthy eye, without glaucoma, will resist the cell damage that would otherwise be caused by an increase in IOP.
- Anatomically, the LC is generally a cylindrical-shaped, mesh-like structure that includes pores which pass through the structure. It is located at the back of an eye, and is positioned in a hole through the sclera at the ONH where fibers of the optic nerve exit the eye. In addition to supporting these nerve fibers, it is believed that an important function of the LC is to help maintain an appropriate pressure gradient between the inside of the eye (i.e. IOP) and the surrounding tissue. For this purpose, the LC is more sensitive to pressure differences than is the thicker, denser sclera surrounding the ONH. Consequently, it tends toward a measurable change in its configuration with increased IOP. Importantly, it is believed that configuration changes in the LC contribute to glaucoma.
- Mathematical models of anatomical structures, such as components of the eye, can be very helpful diagnostic tools. In particular, whenever an anatomical structure is somehow forced to change, a Finite Element Model (FEM) is known to be helpful for evaluating the consequences of the change. For example, U.S. patent application Ser. No. 12/205,420 for an invention entitled “Finite Element Model of a Keratoconic Cornea” which is assigned to the same assignee as the present invention, discloses a mathematical methodology for predicting the condition of an eye in response to a proposed surgical procedure.
- In light of the above, it is an object of the present invention to provide a system and method for predicting the onset of glaucoma before symptoms of the disease become apparent. Another object of the present invention is to identify candidates for the pharmacological treatment of glaucoma, and to provide information for subsequently establishing the treatment regimen. Yet another object of the present invention is to provide a system and method for mathematically modeling the Lamina Cribrosa (LC) to create a pressure response profile for comparison with empirical data to predict the onset of glaucoma. Still another object of the present invention is to provide a system and method for predicting the onset of glaucoma that is easy to implement, is simple to use and is comparatively cost effective.
- In accordance with the present invention, a system and method for diagnosing the onset of glaucoma in an eye involves evaluating anatomical parameters under various pressure conditions. More specifically, the parameters to be evaluated are associated with tissue of the Optical Nerve Head (ONH) in the eye. For this evaluation, the present invention relies on the use of a Finite Element Model (FEM) that replicates the ONH. In particular, this evaluation is based on the comparison of an empirical statistic with a profile that is generated by the FEM in response to a simulated pressure differential.
- In detail, the FEM comprises a plurality of mathematical tensor elements, with each individual element representing anatomical tissue at a particular location on the ONH. Structurally, the FEM substantially replicates the ONH as a cylindrical shaped body having a first end surface and a second end surface, with a cylindrical surface extending between the peripheries of the two end surfaces. For this configuration, tensor elements of the FEM representing the Prelaminar Neural Tissue (PrNT) are arranged on the first end surface. Elements representing Postlaminar Neural Tissue (PoNT) are arranged on the second end surface. And, between the PrNT and the PoNT, tensor elements representing the Lamina Cribrosa (LC) are located inside the cylinder shape. Also, tensor elements of the FEM representing the sclera are arranged on the cylindrical surface. Further, these sclera elements include a plurality of fiber elements that transition in an outward direction from a substantially circumferential orientation at the cylindrical surface to an increasingly spiral orientation with increasing distance from the cylindrical surface. This is done to add stability to the FEM.
- In operation, anatomical data is obtained from a patient for use in programming the FEM. More specifically, this acquisition of data is done in two steps. First, stress-strain measurements (data) are taken from the ONH when the eye is under a first pressure (e.g. 2 kPa). This creates a first image of the ONH. Second, the procedure is repeated to obtain stress-strain measurements (data) when the eye is under a second pressure (e.g. 8 kPa). This creates a second image of the ONH. Data from the first and second images are then programmed into the FEM.
- Once the FEM has been programmed with the first and second images of the ONH, the tensor, parameters of the FEM are varied from a base condition (e.g. the first image) to obtain a profile of the ONH. Preferably, this variation covers a range of pressures (e.g. range of 8 kPa) and is done in a sequence of pressure increments, with each increment being approximately 1 kPa. The resultant profile is then compared with empirical data to predict an onset of glaucoma.
- The novel features of this invention, as well as the invention itself, both as to its structure and its operation, will be best understood from the accompanying drawings, taken in conjunction with the accompanying description, in which similar reference characters refer to similar parts, and in which:
-
FIG. 1 is a schematic of the system of the present invention shown in its relationship with an eye (shown in cross section); -
FIG. 2 is an enlarged view of the Lamina Cribrosa (LC), and the Optical Nerve Head (ONH) of the eye shown inFIG. 1 , and -
FIG. 3 is a perspective view of a Finite Element Model presented as a mathematical representation of the LC for use with the present invention. - Referring initially to
FIG. 1 , a system for use with the present invention is shown and is generally designated 10. As shown, thesystem 10 includes animaging unit 12 that has an illumination means (not shown) for directing light along abeam path 14. Further, thesystem 10 includes apressure unit 16, andFIG. 1 shows that both theimaging unit 12 and thepressure unit 16 provide input for creation of a mathematical Finite Element Model (FEM) 18. - A
computer 20 is shown inFIG. 1 with connections to both theFEM 18 and adatabase 22. As one of its functions, thecomputer 20 is used in thesystem 10 to run aprogram 24 for an operation of theFEM 18. More specifically, theprogram 24 subjects theFEM 18 to incremental pressure increases that simulate the progress of glaucoma. For another function, thecomputer 20 is used to compare the output from theFEM 18 with empirical data from adatabase 22. Thus, the input from theFEM 18 to thecomputer 20 is a consequence of theprogram 24. On the other hand, input from thedatabase 22 to thecomputer 20 is empirical data that has been clinically collected from a plethora of different patients. - As is appreciated with reference to
FIG. 1 , thesystem 10 is intended for use in evaluating aneye 26. More specifically, thesystem 10 is to be used for evaluating the Lamina Cribrosa (LC) 28 that is located in the Optical Nerve Head (ONH) 30 of theeye 26. The anatomical aspects of theONH 30 and theLC 28 as they pertain to the present invention will be best appreciated with reference toFIG. 2 . - In
FIG. 2 it will be seen that theLC 28 is surrounded bysclera 32, and includesnerve fibers 34 that extend from theretina 36 as they exit from theeye 26 and into theoptic nerve 38. Further, theLC 28 is a mesh-like structure that includes a plurality ofpores 40. Functionally, theLC 28 is continuously subjected to intraocular pressure from thevitreous body 42 of theeye 26. AnFEM 18 that mathematically replicates theLC 28 is shown inFIG. 3 . -
FIG. 3 shows that aFEM 18 for mathematically representing theLC 28 substantially replicates a cylindrical shapedbody 44. As such thebody 44 has afirst end surface 46 and asecond end surface 48, with acylindrical surface 50 that extends between the end surfaces 46 and 48 to represent the periphery of theLC 28. As intended for the present invention, thefirst end surface 46 of thebody 44 is used to replicate the location of Prelaminar Neural Tissue (PrNT) of theLC 28. And, similarly, thesecond end surface 48 of thebody 44 is used to replicate the location of Postlaminar Neural Tissue (PoNT) of theLC 28. - For the mathematical aspects of the
FEM 18, a plethora ofelements 52 are arranged over thefirst end surface 46 of thebody 44 for this purpose (Note: theelements 52 shown inFIG. 3 are only exemplary). Also, a plethora of elements 54 (also exemplary) are arranged on the second end surface. Between the end surfaces 46 and 48, and within thebody 44, areelements 56 of theFEM 18 that represent theLC 28 itself. Further,fiber elements 58 that represent the sclera 32 are arranged on thecylindrical surface 50 of theFEM 18. More specifically, thesefiber elements 58 are arranged to transition in an outward direction from thecylindrical surface 50 with a transition characterized by a change from a substantially circumferential orientation at thecylindrical surface 50 to an increasingly spiral orientation with increasing distance from thecylindrical surface 50. The purpose here is to replicate the stability provided by thesclera 32 for theLC 28. As will be appreciated by the skilled artisan, each of theelements FEM 18 are mathematical tensors that can be individually programmed to represent biomechanical properties of tissue at a location in the anatomical structure being replicated. - In the operation of the
system 10 of the present invention, aneye 26 that is to be evaluated is subjected to a pressure differential by thepressure unit 16. More specifically, this pressure differential will preferably be over a range of about 8 kPa. First, theeye 26 is subjected to an initial pressure (e.g. 2 kPa). Witheye 26 under this initial pressure, theimaging unit 12 is employed to create an image of theLC 28. In detail, this imaging can involve well known techniques that include the use of confocal microscopy or Optical Coherence Tomography (OCT) for general imaging. It can also involve Second Harmonic Generation (SHG) imaging for determining micromorphology parameters. For instance, the location and sizes ofpores 40 in theLC 28 may be best determined by SHG imaging. In any event, these imaging techniques are employed to obtain measurable data concerning biomechanical stress/strain parameters of tissue in theLC 28. Next, theeye 26 is subjected to a subsequent pressure (e.g. 10 kPa) by thepressure unit 16. Again, while theeye 26 is under this subsequent pressure, images of theLC 28 are made and biomechanical stress/strain parameters of tissue in theLC 28 of theeye 26 are taken. All of this information is then used to program theFEM 18. - Once the
FEM 18 has been programmed with biomechanical stress/strain parameters taken from theeye 26, theFEM 18 is manipulated through a sequence of pressure increments. More specifically, theFEM 18 is first observed at a base pressure, and is then subsequently observed at increased pressure levels. These levels will typically be at intervals of about 1 kPa. During this process, changes in the tensor parameters of theelements eye 26. - As indicated in
FIG. 1 , the pressure response profile that is created as disclosed above is provided as input to thecomputer 20. Thecomputer 20 is then used to compare the pressure response profile with empirical data retrieved from thedatabase 22. In accordance with this comparison, it can then be determined whether theeye 26 is a glaucoma candidate that should receive pharmacological treatment. - While the particular System and Method for Assessing Risk of Glaucoma Onset as herein shown and disclosed in detail is fully capable of obtaining the objects and providing the advantages herein before stated, it is to be understood that it is merely illustrative of the presently preferred embodiments of the invention and that no limitations are intended to the details of construction or design herein shown other than as described in the appended claims.
Claims (6)
1. A method for determining the onset of glaucoma which comprises the steps of:
creating a first image of an Optical Nerve Head (ONH) of a patient at a first pressure;
creating a second image of the ONH at a second pressure;
assessing the first image and the second image to establish data of stress-strain characteristics for tissue of the ONH at each of a plurality of locations in the ONH;
programming a Finite Element Model (FEM) of an ONH with the data established in the assessing step, the FEM having elements respectively representative of a Lamina Cribrosa (LC), Prelaminar Neural Tissue (PrNT), Postlaminar Neural Tissue (PoNT), and Sclera, wherein each element of the FEM is defined by mathematical parameters based on the data;
varying parameters of the FEM to obtain a profile for the ONH of the patient; and
evaluating the profile in comparison with empirical statistics to predict an onset of glaucoma.
2. A method as recited in claim 1 wherein the profile is obtained from a plurality of simulated pressure changes on the FEM, wherein the pressure changes are made through a range of approximately 8 kPa, with each pressure change resulting from a pressure increment equal to approximately 1 kPa.
3. A method as recited in claim 1 wherein the first image is created at a pressure of approximately 2 kPa and the second image is created at a pressure of approximately 8 kPa.
4. A method as recited in claim 1 wherein the FEM substantially replicates a cylindrical shaped body having a first end surface and a second end surface with a cylindrical surface therebetween, and further wherein elements of the FEM representing the PrNT are arranged on the first end surface, elements of the FEM representing the PoNT are arranged on the second end surface, elements of the FEM representing the LC are located between the first end surface and the second end surface, and elements of the FEM representing the sclera are arranged on the cylindrical surface.
5. A method as recited in claim 4 wherein the elements of the FEM representing the sclera include a plurality of fiber elements, with the fiber elements transitioning in an outward direction from the cylindrical surface, with the transition being characterized by a change from a substantially circumferential orientation at the cylindrical surface to an increasingly spiral orientation with increasing distance from the cylindrical surface, to add stability to the FEM.
6. A method as recited in claim 5 wherein the elements Of the FEM representing the LC include simulated pores, wherein a location and a size for each pore is determined by Second Harmonic Generation (SHG) imaging of the ONH.
Priority Applications (1)
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US13/371,122 US8650018B2 (en) | 2009-03-04 | 2012-02-10 | System and method for assessing risk of glaucoma onset |
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US12/397,954 US8137271B2 (en) | 2009-03-04 | 2009-03-04 | System and method for assessing risk of glaucoma onset |
US13/371,122 US8650018B2 (en) | 2009-03-04 | 2012-02-10 | System and method for assessing risk of glaucoma onset |
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US12/397,954 Division US8137271B2 (en) | 2009-03-04 | 2009-03-04 | System and method for assessing risk of glaucoma onset |
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US13/371,084 Active 2029-06-10 US8562530B2 (en) | 2009-03-04 | 2012-02-10 | System and method for assessing risk of glaucoma onset |
US13/371,122 Active 2029-07-13 US8650018B2 (en) | 2009-03-04 | 2012-02-10 | System and method for assessing risk of glaucoma onset |
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US13/371,084 Active 2029-06-10 US8562530B2 (en) | 2009-03-04 | 2012-02-10 | System and method for assessing risk of glaucoma onset |
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Cited By (2)
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US9265418B2 (en) | 2012-01-27 | 2016-02-23 | Canon Kabushiki Kaisha | Image processing apparatus, image processing method, and program |
US9275283B2 (en) | 2010-11-09 | 2016-03-01 | Kabushiki Kaisha Topcon | Fundus image processing apparatus and fundus observation apparatus |
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WO2013096590A1 (en) | 2011-12-20 | 2013-06-27 | Research Foundation Of The City University Of New York | Method for screening a drug in retinal tissue |
JP5924955B2 (en) * | 2012-01-27 | 2016-05-25 | キヤノン株式会社 | Image processing apparatus, image processing apparatus control method, ophthalmic apparatus, and program |
US10553130B2 (en) * | 2012-05-03 | 2020-02-04 | Regents Of The University Of Minnesota | Systems and methods for analyzing surgical techniques |
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US9265418B2 (en) | 2012-01-27 | 2016-02-23 | Canon Kabushiki Kaisha | Image processing apparatus, image processing method, and program |
Also Published As
Publication number | Publication date |
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EP2226000B1 (en) | 2017-08-23 |
EP2226000A1 (en) | 2010-09-08 |
JP5559570B2 (en) | 2014-07-23 |
US8137271B2 (en) | 2012-03-20 |
US20100228114A1 (en) | 2010-09-09 |
US8650018B2 (en) | 2014-02-11 |
US20120140178A1 (en) | 2012-06-07 |
JP2010201174A (en) | 2010-09-16 |
US8562530B2 (en) | 2013-10-22 |
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